decisionhealth Newsletters, Part B News - 2009 Issue 11 (November)
4 ways to convince your carrier to cover MRIs measuring blood flow
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Article Overview
This premium article explains how providers and cardiology groups can approach payers after a CMS coverage reversal related to cardiac MRI blood-flow measurement services. It is aimed at medical coders, billing staff, and cardiology practices that need to understand the general coverage landscape, local carrier decision-making, and the timing considerations surrounding a new set of MRI-related CPT services.
Why This Topic Matters
Coverage policy can determine whether a service is reimbursed, delayed, or denied, so understanding the carrier response is important for billing, compliance, and revenue cycle planning. The article highlights the broader coverage process and payer communication issues that affect access to these MRI services.
What You Will Learn
- How a CMS coverage change can affect carrier-level payment decisions
- Why payer communication and advocacy may influence coverage timing
- How broader payer adoption and specialty group support can affect a coverage discussion
- Why timing and local coverage decisions matter for reimbursement planning
Who Should Read This
- Medical coders
- Cardiology billing staff
- Revenue cycle professionals
- Physician practices
- Coverage and reimbursement specialists
Codes Discussed
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